**2.10 Vegetarian and vegan diet**

Both vegetarian and vegan diets are centered around cereal, fruits, vegetables, legume and nuts. However, vegetarian diets may include dairy products and/or

#### **Figure 1.**

*Mediterranean diet: Recommends consumption of mainly whole grains, vegetables, fruits, nuts and legumes. Limiting animal protein to 0–2 servings and one serving of dairy (as a source of calcium). Consumption of red meat, saturated fats and processed foods is not encouraged and recommended to consume only sparingly. Moderate consumption of wine is now recognized as part of this diet.*

**327**

*Nutritional Interventions: Diet Modifications, Nutritional Supplements, Complementary…*

eggs. It reduced body weight, but reduction of HbA1C was not significant. There is very little research on the long term effects of these diets. And it is known that

A major portion of the calories in this diet is protein with 30% of energy from proteins. Weight loss occurred with females losing total fat and abdominal fat mass. But total lean mass also decreased. Although it improved glucose control and decreased HbA1C (0.28%) [20]. Low fat cottage cheese, cheese tofu, red meat, chicken, peanut butter, fish and lentils were some of the constituents of this diet. Diet should be individualized and patients must account for cardiometabolic risk

Based on the knowledge about the effects of different macronutrients on circulating glucose levels many other popular diets have been introduced. These diets have not been studied using controlled trials so the outcomes are not authenticated. These diets include the Paleo diet, Atkins diet/keto diet, Nutrisystems etc. They are all focused on weight loss. It is important to account for the different macro and micronutrients on maintaining normal metabolism in the body. Therefore, a carbohydrate free or a fat free diet or vegan diet can be very deleterious to health,

Paleo diet also referred to as the Hunter-Gatherer diet or Stone Age diet became popular as the evolution of human diets was recognized from simple diets to complex highly processed diets in the modern world. The Paleo diet simulates diet eaten by the Stone Age humans who were hunters and collected food that was readily available in nature like meat (mainly lean), organ meats, fish, vegetables, fruits, nuts and seeds [21]. This diet is reported to improve insulin resistance and showed significant decrease in HbA1C, body weight and BMI is a small clinical trial [22, 23]. The main

issues with this diet is that patients have low vitamin D and calcium [24].

The Atkins diet was promoted by Dr. Robert C Atkins, a cardiologist and recommended a low carbohydrate with high protein and fat diet. There are several modifications now available and are referred to as Keto diet. This diet shifts the energy needs of the body from carbohydrate to fats, therefore, The diet includes sources of high fat content like butter, nuts and cream [25]. The low carbohydrate diet recommends the use of 100 g/d of carbohydrates with 50–60% fat and 20–30% protein and the very low carbohydrate diet recommends <50 g/d of carbohydrates. Weight loss, low insulin levels, deceased hunger are some of the benefits reported [26, 27]. In T1DM patients the carbohydrate levels have to be adjusted to the insulin levels to maintain post prandial glucose levels and reduce hypoglycemia [28]. The preferred source of energy in the body is glucose, restricting this macronutrient forces the body to use fats for energy production. Unfortunately, when this happens many ketone bodies are produced and this is deleterious to the metabolism

*DOI: http://dx.doi.org/10.5772/intechopen.94645*

**2.11 High protein diet**

**2.12 Other diets**

*2.12.1 Paleo diet*

*2.12.2 Atkins/keto diet*

especially in the long run.

patients on these diets may lack in essential nutrients [10].

and renal profile, long term effects are not known [10].

unless there is a balance in the nutrient intake.

*Nutritional Interventions: Diet Modifications, Nutritional Supplements, Complementary… DOI: http://dx.doi.org/10.5772/intechopen.94645*

eggs. It reduced body weight, but reduction of HbA1C was not significant. There is very little research on the long term effects of these diets. And it is known that patients on these diets may lack in essential nutrients [10].

## **2.11 High protein diet**

*Type 2 Diabetes - From Pathophysiology to Cyber Systems*

This diet is more popular and 30–40% of the diet consists of monounsaturated fats. Legumes, fruits, vegetables, nuts, whole grain, fish and moderate ingestion of wine. Has a positive effect on glycemic control and reduces the incidence of diabetes by 52% (**Figure 1**). The body weight regain with this diet was low. The major problem

Combination of low carbohydrate ketogenic diet and very low calorie diet. Patients prescribed this diet are started off on a very low calorie diet (800 calories/ day) for the first six months and then the calories are increased gradually. At the beginning carbohydrate intake is limited to 20-50 g/day with 1.2–1.5 g/Kg of proteins [19]. Successful in weight loss and lowering HbA1C and fasting glucose. However, there is a low adherence rate among patients and they may increase weight regain

Both vegetarian and vegan diets are centered around cereal, fruits, vegetables, legume and nuts. However, vegetarian diets may include dairy products and/or

*Mediterranean diet: Recommends consumption of mainly whole grains, vegetables, fruits, nuts and legumes. Limiting animal protein to 0–2 servings and one serving of dairy (as a source of calcium). Consumption of red meat, saturated fats and processed foods is not encouraged and recommended to consume only sparingly.* 

*Moderate consumption of wine is now recognized as part of this diet.*

**2.8 Mediterranean diet**

quickly [10].

is that adherence rate was low [10].

**2.9 Protein sparing modified diet**

**2.10 Vegetarian and vegan diet**

**326**

**Figure 1.**

A major portion of the calories in this diet is protein with 30% of energy from proteins. Weight loss occurred with females losing total fat and abdominal fat mass. But total lean mass also decreased. Although it improved glucose control and decreased HbA1C (0.28%) [20]. Low fat cottage cheese, cheese tofu, red meat, chicken, peanut butter, fish and lentils were some of the constituents of this diet. Diet should be individualized and patients must account for cardiometabolic risk and renal profile, long term effects are not known [10].
